Flashes & Floaters

Floaters are tiny clumps of cells, protein, or debris that form within the vitreous gel. As these opacities float through the vitreous cavity, they cast shadows on the retina, which you perceive as spots, cobwebs, or squiggly lines drifting across your field of vision. Floaters are often more noticeable when looking at a plain, bright background such as a white wall or blue sky.

Flashes (photopsia) appear as brief flickers or streaks of light in the peripheral vision. They are caused by mechanical traction on the retina as the vitreous gel pulls away from the retinal surface. This traction stimulates the retina to send signals to the brain that are interpreted as light, even though no external light is present.

While these changes are usually harmless, in some cases the vitreous may pull hard enough to cause a retinal tear. If fluid passes through this tear and accumulates beneath the retina, it can cause a retinal detachment, a true ocular emergency.

Common symptoms include:

• Small spots, dots, or lines drifting across your vision
• Cobweb like shapes
• Squiggly or thread like strands
• Brief flashes of light, particularly in the peripheral vision
• Flashes that are more noticeable in dim lighting or when moving your eyes
• A ring shaped floater (Weiss ring) in one eye

Warning signs requiring urgent attention:

• A sudden increase in the number of floaters (like a shower of black dots)
• A sudden onset of flashes
• A curtain like shadow or dark area progressing across your visual field
• A sudden decrease in vision
• A history of high myopia, prior cataract surgery, or ocular trauma

If you experience any of these warning signs, you should seek an urgent eye examination the same day.

When you visit us at Sutherland Eye Surgeons, some of the tests that we perform may include:

• Visual acuity testing
  Assessment of your best corrected vision

• Slit lamp examination
  Evaluation of the anterior segment and assessment for any associated inflammation or bleeding

• Dilated fundal examination
  Drops are instilled to dilate your pupils, allowing a thorough examination of the retina, including the peripheral retina where tears most commonly occur

• Scleral depression
  Gentle pressure applied to the outside of the eye to allow visualisation of the far peripheral retina. This is essential to detect subtle retinal tears that may not be visible otherwise

• Optical coherence tomography (OCT)
  Imaging of the macula to assess for any associated pathology, including macular holes or oedema

• B-scan ultrasonography
  May be performed if there is significant bleeding (vitreous haemorrhage) that prevents clear visualisation of the retina

For benign floaters
Reassurance and monitoring are provided. Most benign floaters become less noticeable over time as they settle out of the visual axis and as the brain learns to ignore them. Surgery to remove floaters is rarely indicated and is reserved for severe cases significantly affecting quality of life.

For retinal tears
Prompt treatment with in rooms laser photocoagulation or cryotherapy is performed to create a chorioretinal scar that seals the retinal break, preventing fluid from passing through and causing a detachment. This is a quick and simple procedure that takes approximately 10–15 minutes.

For retinal detachments
Surgery is required to reattach the retina and preserve vision. This may involve a vitrectomy (removing the vitreous gel and reattaching the retina), scleral buckle (placing a silicone band around the eye to indent the wall and relieve traction), or pneumatic retinopexy (injecting a gas bubble to push the retina back into place).